Major Depressive Disorder

Questions discussed in this category

How do you balance the benefits of treating depression versus the risk of transition to mania? Do you consider stopping the medication as soon as the ...

12 Answers available

What is your pharmacological approach to treating depressive disorders in patients who develop serotonin toxicity?

How does the development of serotonin toxicity/syndrome change your usage of serotonergic medications? Which medications/classes of medications do you...

1 Answer available

How do you counsel patients on the risks and benefits of antidepressant use during pregnancy?

How do you approach shared decision-making when patients express hesitancy about medication exposure in utero? What is your approach when a patient is...

3 Answers available

How do you treat decreased libido from SSRIs?

Any alternatives to drug holiday, bupropion, sildenafil, and yohimbine?

13 Answers available

How do you manage patients who develop SIADH secondary to an SSRI but have had a strong positive response to that same medication?

What monitoring strategies (e.g., sodium checks, fluid restriction, dose adjustments) have you found most practical in these cases? In what situations...

1 Answer available

How do you counsel patients with mild to moderate depression interested in using St. John's Wort?

4 Answers available

How do you approach patient requests for long-term disability for major depressive disorder?

1 Answer available

How do you counsel patients with depression about the role exercise may play in alleviating depressive symptoms?

How do you educate patients about the role exercise may play in depression treatment? What type, frequency, and intensity of exercise do you recommend...

2 Answers available

When do you consider starting an antidepressant without a mood stabilizer in a patient with a historical diagnosis of bipolar II disorder who has not had hypomanic episodes in many years?

What factors guide your assessment of the risk for antidepressant-induced hypomania for mood destabilization? Which antidepressants do you find safest...

2 Answers available

What antidepressant medications do you usually use alongside ketamine or esketamine treatment in patients with difficult-to-treat depression?

In your clinical practice, have you noticed whether concurrent pharmacotherapy improves the durability of ketamine’s effects? Which medications ...

2 Answers available

When do you refer a patient with difficult-to-treat depression for esketamine nasal spray versus IV ketamine treatment?

What clinical factors influence your decision? Are there specific practice settings or insurance considerations that push you toward one option over t...

3 Answers available

What strategies have you found most effective for obtaining prior authorization for newer antipsychotics and antidepressants?

How do you determine which medications are most likely to require prior authorization? How do you streamline the prior authorization process and fit i...

2 Answers available

What is your approach to recommending bright light therapy devices to patients with (seasonal) depressive disorders?

Which ones do you recommend, particularly when cost is prohibitive? Which has the highest efficacy? How do you counsel patients on using them?

7 Answers available

What is your next step in management for patients who develop sexual side effects on an SSRI (anorgasmia, low libido, etc.) but are responding well to therapy?

Related Mednet discussion on low libido and SSRIs

3 Answers available

How do you decide when to initiate medical workup (e.g., thyroid, B12, infection) in a geriatric patient experiencing new onset or worsening low mood?

2 Answers available

Have you completed any training to prepare for offering psilocybin treatment in the event that it eventually becomes FDA-approved for difficult-to-treat depression?

If yes, what kind of training did you pursue? How do you see psilocybin fitting into your practice (or not)? Are there particular skills you feel woul...

2 Answers available

How do you approach firearm safety counseling for outpatients with elevated suicide risk who do not meet the criteria for involuntary psychiatric hospitalization?

3 Answers available

How do you counsel/approach antidepressant use in patients planning to utilize or self-administer psychedelics for chronic PTSD or depression?

With patients increasingly accessing psychedelics through online forums or home-grown sources for chronic PTSD and depression, how should psychiatrist...

1 Answer available

How do you view the risk of tardive dysinesia and other side effects in your female patients with treatment-resistant depression who are stable on an atypical antipsychotic?

Given the concern about potential TD in female patients treated with second-generation atypical antipsychotics as an adjunct to antidepressants, are y...

5 Answers available

What is your approach to delayed or inhibited ejaculation related to SSRI sexual dysfunction?

What are other ways to treat this beyond reducing the dose / switching medications? What interventions have you had the most success with?

1 Answer available

What is your experience with transcutaneous vagal nerve stimulation for the treatment of anxiety disorders and major depressive disorder?

1 Answer available

How have you gone about implementing TMS in your practice or institution?

Logistical barriers in implementing TMS can include equipment acquisition, funding, staffing, training, reimbursement, or institutional approval. What...

3 Answers available

How do you incorporate rating scales such as the PHQ-9 into your treatment of major depressive disorder?

Do you administer them at intake, follow-up, or both? How frequently do you use them? How do you gauge the accuracy and validity of patients’ re...

4 Answers available

How do you define treatment-resistant depression in your practice?

What strategies do you use to counsel patients on continuing an antidepressant until therapeutic doses versus switching agents if they perceive a lack...

1 Answer available

How do you talk to patients about psychedelic clinical trials for the treatment of major depressive disorder or PTSD?

When do you consider referring a patient to a clinical trial? How have patients responded to being offered trial participation? What has your experien...

1 Answer available

When do you consider referring adolescents with major depressive disorder for TMS?

How effective have you found it in this population? Have you encountered any challenges with insurance coverage? How have you identified providers in ...

1 Answer available

How do you facilitate access to interventional treatments such as TMS for patients with difficult-to-treat depression who are on Medicaid?

1 Answer available

How do you counsel patients who are interested in dietary approaches for managing major depressive disorder?

Do you ever recommend specific diets, such as the ketogenic diet? If so, in what clinical contexts?

1 Answer available

What doses of lithium have you found effective in reducing suicidal ideation?

6 Answers available

What approaches have you found most helpful for concurrent severe major depressive disorder and alcohol use disorder?

6 Answers available

What are your considerations when treating insomnia in perimenopausal patients with comorbid anxiety or mood disorders?

6 Answers available

How do you approach antidepressant selection in patients with prominent fatigue but minimal mood symptoms?

6 Answers available

How do you decide between initiating antidepressants vs. hormone replacement therapy for post-menopausal depression?

2 Answers available

When do you choose to switch to antidepressants vs augmentation in treatment-resistant depression?

4 Answers available

How do you approach treatment-resistant depression and anxiety related to menopause refractory to SSRI/SNRIs and hormone replacement therapy?

1 Answer available

Do you screen for MTHFR polymorphisms in your patients with treatment-resistant depression?

1 Answer available

How do you support recovery in patients with MDD and AUD experiencing anhedonia and social isolation after losing alcohol-based social networks?

1 Answer available

Would you be comfortable using isotretinoin in a female teenage patient who has a history of depression that is now stable but with a prior suicide attempt two years ago?

7 Answers available

How do you manage emotional blunting due to SSRIs/SNRIs?

7 Answers available

Would you consider over-the-counter dextromethorphan (low dose, slow titration) as augmentation in MDD?

Considering a growing interest in the use of dextromethorphan for depression (Majeed et al., PMID 33682569).

2 Answers available

What do you do when a patient experiences multiple rounds of antidepressant-related tachyphylaxis?

4 Answers available

What varying approaches do you take in suicide risk assessments?

Do you use different approaches in different settings (i.e., the ED vs. outpatient clinic)? Do you use different approaches for chronic vs acute suici...

3 Answers available

How do you approach managing depression symptoms in patients who have had repeated high risk of bleeding?

When do you determine SSRI therapy is unsafe to pursue in such situations?

2 Answers available